Prof. Andrew Boulton, MD, DSc (Hon), FACP, FICP, FRC
President, International Diabetes Federation
Chair, EURADIA: Alliance for European Diabetes Research
Professor of Medicine, University of Manchester and Visiting Professor, University of Miami, FL
Consultant Physician, Manchester Royal Infirmary
Past-President, European Association for the Study of Diabetes
The COVID-19 pandemic is of great concern to people living with diabetes as they can be more vulnerable to the severe effects of the virus.
The latest figures from The International Diabetes Federation (IDF) show that around 10% of people worldwide live with diabetes. The condition is also a leading cause of several life-threatening or debilitating complications, including blindness, heart attack, stroke, lower-limb amputation and kidney failure.
IDF is highlighting three concerns for people living with diabetes during the coronavirus crisis: vulnerability, access to care, as well as physical and mental wellbeing.
Protecting the vulnerable
People living with diabetes – particularly those with poorly managed blood glucose levels – are more vulnerable to the severe effects of COVID-19. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications.
Studies indicate that, depending on the global region, up to 50% of people with COVID-19 had diabetes. In the UK, 25% of deaths related to COVID-19 have occurred in people with diabetes.
COVID-19 demands have disrupted other vital medical supplies
The restrictions put in place to fight the spread of COVID-19 in some countries have disrupted the production of vital medications and impacted supply chains. This could create shortages in some regions, leaving people with diabetes unable to get hold of essential medicines.
It is critical that governments recognise that people with diabetes can be more vulnerable to COVID-19 – and at increased risk of dying.
People living with diabetes require uninterrupted access to essential medicines, supplies, technologies and care. People with type 1 diabetes, for example, require insulin to survive. Disruption to medical supplies or care can make it more difficult for people with diabetes to manage their condition and could lead to complications if not addressed.
Lockdown measures can make it difficult to attend health appointments for advice on diabetes management and prevention. Furthermore, the reallocation of healthcare resources has made the situation worse.
Lockdown’s impact on wellbeing of people living with diabetes
Regular exercise and a balanced diet are important in managing diabetes and preventing its complications. The imposition of social distancing measures to reduce COVID-19 have reduced opportunities to exercise and made it more difficult to stick to a healthy diet.
For some, the pandemic has been a considerable cause of stress. We have had reports of people with diabetes avoiding healthcare facilities for fear of contracting COVID-19. As a result, there is a concern that, down the line, many countries may see a spike in complications.
Support for all
It is critical that governments recognise that people with diabetes can be more vulnerable to COVID-19 – and at increased risk of dying. Measures to reduce potential exposure to the virus are of great importance. At the same time, people with diabetes need to manage a complicated condition. Access to care and supplies must be maintained to protect them from serious complications.
People living with diabetes are advised to seek medical attention if they feel unwell. IDF is offering advice about precautions to take during the pandemic. Information, including guidance on how to best maintain physical and mental health can be found at www.idf.org/covid-19.